Forum - Questions & Answers

Mar 11th, 2010 - ASTOUGH 15 

Preventative code

Is it ok to bill the codes 99401 or 99402 with diagnosis code V25.49 or V07.4? Insurances have been rejecting these for me stating that it is a medical diagnosis billed with a preventative procedure. If it's not ok, what procedure code would I use - 99211-99214?

Mar 11th, 2010 - nmaguire   2,606 

99401

CPT codes 99401–99409 report counseling risk factor reduction and behavioral change intervention services provided at an encounter separate from the preventive medicine examination. Individual preventive medicine counseling codes 99401–99404 are used to report counseling services in areas such as family problems, diet and exercise, substance abuse, sexual practices, injury prevention, dental health, and diagnostic and laboratory test results available at the time of the encounter. You bill what you do. Look at codes V61 series, V25 etc. Ask them what they consider appropriate for preventive medicine counseling?



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